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6: Common Risk Allele Results
In the case of breast cancer, several alleles that
increase susceptibility have been identied.
Pathogenic mutations in the BRCA1 and
BRCA2 genes associated with the Mendelian
disorder Hereditary Breast and Ovarian Cancer
Syndrome are associated with lifetime risks for
breast cancer of 40-80%. In contrast, more than
70 other common alleles have been associated
with breast cancer susceptibility, most of which
confer only a mild to moderate increase in
risk. Thus, identifying one of these common
alleles would not have the same implications
for medical management as would nding
a pathogenic mutation in BRCA1 or BRCA2.
To what extent the associated symptoms
are expressed in the presence of the variant
is captured by a term called penetrance. If
it is not always expressed, it is considered
incompletely penetrant.
If an associated allele is identied, it may explain disease susceptibility. Common risk alleles with
a known association with a condition can inform an individual of an increased or decreased risk
of developing the condition in question; however, the degree of certainty is often unknown. The
presence of a common risk allele can indicate a need for increased surveillance, while a negative
result implies a risk similar to the general population.
Common risk alleles have unclear implications for family members. In addition, the clinical
sensitivity of tests for common risk alleles is not necessarily high. Common complex diseases are
caused by multiple genetic and environmental factors, many of which remain unknown.
References:
1. Hirschhorn, J.N., Lohmueller, K., Byrne, E., Hirschhorn, K. “A comprehensive review of genetic
association studies.” Genet Med. 2002 Mar-Apr;4(2):45-61.
2. Raychaudhuri, S. “Mapping rare and common causal alleles for complex human diseases.”
Cell. 2011 Sep 30;147(1):57-69.
3. Geerts, W.H., et al. “Prevention of Venous Thromboembolism: American College of Chest
Physicians Evidence-Based Clinical Practice Guidelines (8
th
Edition).” Chest. 2008;133(6_
suppl):381S-453S.
The average woman in the United States has about a 1
in 8, or 12% chance of developing breast cancer during
her lifetime. Genetic variants in highly penetrant genes
(BRCA1 and BRCA2) confer a signicantly higher risk of
being diagnosed with breast cancer, while changes in other
genes have a more moderate impact on risk.